Healthcare Provider Details

I. General information

NPI: 1063021202
Provider Name (Legal Business Name): NATALIE P ARAGON M.A., LMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2020
Last Update Date: 07/23/2020
Certification Date: 07/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4221 N BROADWAY AVE
MUNCIE IN
47303-1015
US

IV. Provider business mailing address

4221 N BROADWAY AVE
MUNCIE IN
47303-1015
US

V. Phone/Fax

Practice location:
  • Phone: 765-282-7150
  • Fax: 765-282-9166
Mailing address:
  • Phone: 765-282-7150
  • Fax: 765-282-9166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number88001094A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: